Epidemiology of plaque-induced gingivitis among 12-15-year-old Chinese schoolchildren: A study based on the 2018 case definition.

AIM: To explore the epidemiology of plaque-induced gingivitis and related factors among Chinese adolescents. MATERIALS AND METHODS: This cross-sectional survey comprised 118,601 schoolchildren in the 12-15-year age group. Data came from the National Oral Health Survey in mainland China. The field investigation was conducted according to the World Health Organization guidelines. The new 2018 case definition for plaque-induced gingivitis was used. Participants underwent clinical examinations and completed a structured questionnaire. Bleeding on probing (BOP) was performed on all teeth. Multinomial logistic regression was used to explore the factors related to the extent of gingivitis. RESULTS: Nearly half of the study population (47.3%) had plaque-induced gingivitis; 23.9% and 23.3% presented with localised and generalised gingivitis, respectively. The first molars were the most affected by BOP. Well-established factors, such as demographic characteristics, socioeconomic status, local factors and smoking habits, were significantly associated with the extent of gingivitis. Odds ratios for localised and generalised gingivitis increased with the decrease in frequency of toothbrushing with a fluoride dentifrice. CONCLUSIONS: The study population had high plaque-induced gingivitis prevalence. The extent of gingivitis appeared to have a dose-response relationship with the frequency of toothbrushing with a fluoride dentifrice.

Interdental cleaning aids are beneficial for oral health at 7-year follow-up: Results from the Study of Health in Pomerania (SHIP-TREND).

AIM: To estimate association between the use of interdental cleaning aids (IDAs) and type on 7-year follow-up levels of interdental plaque, interdental gingival inflammation, interdental periodontitis severity, the number of interdental sound surfaces and the number of missing teeth in a population-based cohort study. MATERIALS AND METHODS: We used 7-year follow-up data of 2224 participants from the Study of Health in Pomerania (SHIP-TREND). We applied generalized linear and ordinal logistic models, adjusting for confounding and selection bias using inverse probability treatment weighting and multiple imputation. RESULTS: Flossers were 32% less likely to have higher interdental plaque (iPlaque) levels than non-users of IDAs (odds ratio [OR] = 0.68; 95% confidence interval [CI]: 0.50-0.94); flossing resulted in 5% lower means of iPlaque. Effects on interdental bleeding on probing (iBOP), mean interdental probing depths and mean interdental clinical attachment levels were direction-consistent but statistically non-significant. Interdental brushing was associated with lower follow-up levels for interdental plaque (OR = 0.73; 95% CI: 0.57-0.93) and iBOP (OR = 0.69; 95% CI: 0.53-0.89). IDAs were more effective in reducing iPlaque in participants with periodontitis, whereas iBOP reduction was more pronounced in participants with no or mild periodontitis. The analyses did not suggest that the use of IDAs affected caries. Finally, applying change score analyses, flossing reduced tooth loss incidence (incidence rate ratio [IRR] = 0.71) compared with non-users of IDAs. CONCLUSIONS: Recommending flossing and interdental brushing in dental practices represents an approach to the prevention of gingivitis and consequently periodontitis.

The effect of secondhand smoke exposure on dental caries and gingival health among schoolchildren in Damascus, Syria: a cross-sectional study.

OBJECTIVE: This study aimed to evaluate the effect of secondhand smoke on dental caries and gingival health among schoolchildren in Damascus, Syria. MATERIALS AND METHODS: This was a cross-sectional study. It was carried out at government schools in Damascus, Syria. This study included healthy children aged 10 to 13 years old. Schoolchildren were interviewed to answer the researcher-administered questionnaire to obtain answers regarding demographic information and family smoking behavior. A dental examination was performed by a dentist, and the number of decayed (D), missing (M), and filled (F) permanent teeth (DMFT) was scored based on the World Health Organization (WHO) 1997. A gingival examination was performed using the modified gingival index (MGI) and Silness-Leo plaque index (PI) to assess gingival inflammation and plaque accumulation, respectively. RESULTS: A total of 284 schoolchildren participated. More than half (61.26%) of them were exposed to secondhand smoke (SHS), and about half of them (52.11%) resided in a house with at least one cigarette smoked in a day. About one-third of the passive smokers (33.30%) had poor plaque control, with a statistically significant difference from non-passive smokers (p < 0.05). The multivariate regression model showed that the number of smokers at home was significantly associated with the DMFT score, dental plaque accumulation, and gingival inflammation (p < 0.1). However, the number of cigarettes smoked at home in a day was not a predictor for dental caries and gingival status (p = 1.000). CONCLUSIONS: Within the limitations of this study, the number of smokers at home appears to have more adverse effects on children's oral health compared to the quantity of smoke inhaled. In addition, SHSe was associated with more dental plaque accumulation among schoolchildren.

Clustering of children's oral diseases in families and villages in a rural setting in Egypt.

BACKGROUND: This study assessed the clustering of children' caries experience, plaque accumulation and gingival inflammation in families and villages in Northwestern Egypt and the factors related to the severity of these conditions. METHODS: This was a secondary analysis of a 2019 household survey of children in villages around Alexandria, Egypt. Clinical examination assessed primary and permanent teeth caries experience (dmft/ DMFT using the World Health Organization criteria), plaque accumulation (Plaque Index (PlI)) and gingival inflammation (Gingival Index (GI)). A child questionnaire assessed child's age, sex, the frequency of toothbrushing (at least twice daily versus less) and frequency of consuming eight types of sugary products (daily sugar consumption score, sum of sugary products consumed daily). Mothers' questionnaire assessed the number of children in the family, mother's education (at least high school versus less), at least twice daily toothbrushing and daily sugar consumption similar to the child. Multilevel regression analyses assessed clustering, calculated by the intraclass correlation coefficient (ICC) of the three conditions in families and villages. Regression estimates (B) and 95% confidence intervals (CIs) of individual and family factors were calculated. RESULTS: Complete data were available for 450 children (246 families, seven villages], mean = 9.9 years-old and 56% females. The mean caries experience score = 3.6, mean plaque index = 1.5 and mean gingival index = 1.2. Caries experience, plaque accumulation and gingival inflammation were not clustered in villages (ICC < 0.01) but clustered in families (ICC = 0.10, 0.44 and 0.29). Child factors significantly improved model fit for caries experience and gingivitis (p < 0.001) but not plaque accumulation (p = 0.90). Family factors did not improve any model fit (p > 0.05). Child's age was significantly associated with caries experience (B= -0.48, p < 0.001) and gingival inflammation (B = 0.032, p < 0.001). Children who brushed their teeth twice daily had significantly more caries experience (B = 1.04, p = 0.01). CONCLUSION: The three oral conditions were not clustered in villages but clustered in families. Plaque accumulation showed the greatest within-family clustering. Family factors were not associated with the three conditions and individual factors indicated the need for interventions to promote preventive behaviors and identify families at risk of oral conditions.

Risk Indicators for Noncavitated and Cavitated Carious Lesions in Preschool Children.

OBJECTIVE: The aim of this study was to evaluate the risk indicators associated with noncavitated and cavitated lesions in preschool children. METHODS: The cross-sectional study included 3- to 4-year-old healthy children (N = 741) recruited in a randomised controlled clinical trial. After obtaining written informed consent, parents completed a questionnaire about their child's sociodemographic background and oral health-related behaviours and parents' oral health-related knowledge and attitude. Caries and plaque were evaluated using International Caries Detection and Assessment System-II and Visible Plaque Index (VPI), respectively. Children were grouped according to their oral health status as being caries-free (CF), having only noncavitated lesions (NC), or having cavitated lesions (CL). The least absolute shrinkage and selection operator (LASSO) sparse multinomial regression was used to study the variables using 1 standard error above the minimum criterion set at P < .05. RESULTS: The prevalence of children with NC and CL was 29.1% and 49.4%, respectively, with a prevalence of early childhood caries being 78.5%. The proportion of children who brushed twice or more than twice a day was highest in CF (71.7%), followed by NC (58.3%), and was least in CL (57.7%). A higher percentage of CL children (56.2%) had twice or more than twice the frequency of between-meal snacking than CF (41.7%) and NC (41.1%) (P < .001) children. The variables included with non-zero coefficients in the model were mean parental oral health knowledge, attitude score, and children's mean VPI score, and all were significant for CL; however, in NC, only VPI score was found to be significant. CONCLUSIONS: Poor oral hygiene is the risk indicator associated with the presence of NC in preschool children, whilst poor oral hygiene and poor parental oral health knowledge and attitude are associated with the presence of cavitated lesions.

Better Gingival Status in Patients with Comorbidity of Type 1 Diabetes and Thyroiditis in Comparison with Patients with Type 1 Diabetes and No Thyroid Disease-A Preliminary Study.

Periodontal disease has been postulated as one of the chronic complications of diabetes. The prevalence of autoimmune thyroiditis in type 1 diabetes (T1D) is higher. The aim of the study was to determine the association between the presence of thyroiditis and gingival status in adults with T1D. A total of 264 patients, 119 men aged 18-45, diagnosed with T1D were included. For further analysis, the study group was divided into two subgroups, with or without autoimmune thyroiditis. Gingival status was assessed with the use of gingival indices. Patients diagnosed with T1D and thyroiditis presented lower plaque accumulation (p = 0.01) and lower-grade gingivitis (p = 0.02). Approximal Plaque Index (API) in all study groups correlated positively with age (Rs = 0.24; p = 0.0001), body mass index (BMI) (Rs = 0.22; p = 0.0008), hemoglobin A1c (HbA1c) (Rs = 0.18; p = 0.006), high-sensitivity C-Reactive Protein (hsCRP) (Rs = 0.17; p = 0.009), total cholesterol (T-Chol) (Rs = 0.17; p = 0.01) and negatively with thyroid-stimulating hormone (TSH) (Rs = -0.2; p = 0.02). Stepwise multivariate linear regression analysis indicated TSH, BMI and gender as independent predictors of dental plaque accumulation in patients with T1D. Autoimmune thyroiditis was associated with a lower accumulation of dental plaque and better gingival status in patients with T1D.

Prevalence of white spot lesions and gingival index during orthodontic treatment in an academic setting.

INTRODUCTION: The objective of this study was to determine the prevalence of white spot lesions (WSL) in orthodontic patients in an academic setting. Specific aims include using a novel combination to measure plaque accumulation (PA) and detect the association between WSL and PA and the associations between multiple independent variables. METHODS: Cross-sectional data were collected on 111 patients. To enhance standardization, a combination of plaque-disclosing agents and standardized intraoral photographs was used to analyze plaque index (PI) and WSL for all teeth except molars. Factors including time in fixed appliances (FA), number of teeth, location of the lesions, and demographic information were reported. A multiple linear regression model was used to detect associations between the PI and WSL and the independent variables (P <0.05). RESULTS: Approximately 79.3% of participants had at least one WSL, with a mean of 4 affected teeth per patient. A significant association was found between time in FA and the more severe PI reporting (P <0.001). There was no significant association between WSL and PI or the other variables. WSL was greater in the maxilla than in the mandible. PI was greater on the left than on the right side. Interexaminer reliability was assessed for PI and WSL (κ = 0.93 and 0.92). CONCLUSIONS: The prevalence of WSL for orthodontic patients treated at this institution was greater than previously reported in the literature. In addition, the severity of PI was associated with increased time in FAs. Combining the proposed method of reporting PA facilitates standardization, calibration, and documentation in an academic environment.

Comparing the prevalence of Helicobacter pylori and virulence factors cagA, vacA, and dupA in supra-gingival dental plaques of children with and without dental caries: a case-control study.

BACKGROUND: Helicobacter pylori infection is one of the most common infectious diseases in humans. Dental plaque is considered as a reservoir of this bacterium, which could play an important role in the development of gastrointestinal problems. Our aim was to investigate the prevalence of H. pylori and its virulence factors in dental plaques in children with and without dental caries. METHODS: Among children aged 6 to 12 years, a total of 72 children were enrolled in the study, including 36 cases with total DMFT/dmft > 3 (case group) and 36 participants with total DMFT/dmft < 1 (control group). After removing supra-gingival plaques from the lower first permanent molar teeth, the samples were examined using PCR method for the presence of H. pylori and some of its virulence factors. Statistical analysis was performed using chi-square, Fisher' exact test, t-tests, and logistic regression. RESULTS: Of 72 participants, 40 cases were male, and 32 cases were female. The minimum and maximum values of total DMFT/dmft indices were zero and ten, respectively, and the mean ± SD value of total DMFT/dmft was 2.78 ± 3.22. Except for vegetable consumption (p = 0.045), there was no significant difference between the two groups regarding gastrointestinal disorders, feeding methods in infancy (p = 0.058), frequency of daily brushing (p = 0.808), frequency of dental visits (p = 0.101), and history of dental scaling (p = 0.246) and professional topical fluoride therapy (p = 0.5). Out of 72 samples, 15 cases were positive for H. pylori DNA (20.8%), and there was no significant association between the presence of this bacterium in dental plaque and dental caries (p = 0.281). The frequency of virulence factors detected in 15 H. pylori cases was as follows: cagA in six cases (40.0%), vacAm1 in three cases (20.0%), and vacAs1 in one case (6.7%). There was no significant difference between the groups regarding the prevalence of virulence factors. CONCLUSION: Our results indicate the presence of H. pylori along with some virulence factors in dental plaques as a reservoir of this bacterium in children in Iran. Although there was no significant association between this bacterium and the incidence of dental caries, dental health in children needs to be seriously taken into consideration.

Comparative Analysis of Streptococcus Mutans and Streptococcus Sobrinus from Dental Plaque Samples of Nigerian Pre-school Children with and Without Caries.

BACKGROUND: Early childhood caries (ECC), despite being a preventable disease, remains prevalent in sub-Saharan Africa. This study compared the occurrence of Streptococcus mutans and Streptococcus sobrinus in dental plaque from caries free and caries active Nigerian preschool children. METHODS: Structured questionnaire were administered to eighty (80) mothers to inquire about the sociodemographic characteristics of their children. Diagnosis of dental caries was made according to the diagnostic criteria of the World Health Organization (WHO). Supragingival plaque sample collected from caries free children and children with dental caries (cavitated and non-cavitated lesions) using wooden toothpicks were cultured anaerobically. Samples were cultured in anaerobiosis and isolates obtained were identified based on molecular characterization performed by polymerase chain reaction (PCR) analysis. Statistical package for the social sciences (SPSS 25.0) was used for analysis. RESULTS: Streptococcus mutans was detected in 26(65.0%) children with early childhood caries, and S. sobrinus in 10(25.0%) children with early childhood caries. The presence of S. mutans and S. sobrinus occurring together was associated with a higher deft score. Occurrence of S. mutans did not show significant difference between children with ECC and caries free children (p=0.099), however, the proportion of children with ECC positive for S. sobrinus was significantly higher than that of caries free children (p= 0.003). CONCLUSIONS: S. mutans and S. sobrinus had a similar frequency of occurrence in children with ECC and caries free children. The occurrence of S. mutans alongside S. sobrinus in ECC is related to its severity.

CONTEXTE: La carie de la petite enfance (CPE), bien qu'étant une maladie évitable, reste prévalente en Afrique sub-saharienne. Cette étude a comparé la présence de Streptococcus mutans et Streptococcus sobrinus dans la plaque dentaire d'enfants nigérians d'âge préscolaire avec et sans caries. MÉTHODES: Des questionnaires structurés ont été administrés à quatrevingts (80) mères pour connaître les caractéristiques sociodémographiques de leurs enfants. Le diagnostic de la carie dentaire a été établi selon les critères de diagnostic de l'Organisation mondiale de la santé (OMS). Des échantillons de plaque supragingivale prélevés sur des enfants exempts de caries et des enfants atteints de caries dentaires (lésions cavitaires et non cavitaires) à l'aide de cure-dents en bois ont été mis en culture en anaérobiose. Les échantillons ont été mis en culture en anaérobiose. Les isolats obtenus ont été identifiés sur la base d'une caractérisation moléculaire effectuée par une analyse de réaction en chaîne par polymérase (PCR). Le progiciel statistique pour les sciences sociales (SPSS 25.0) a été utilisé pour l'analyse. RÉSULTATS: Streptococcus mutans a été détecté chez 26(65,0%) enfants atteints de caries de la petite enfance, et S. sobrinus chez 10(25,0%) enfants atteints de caries de la petite enfance. La présence simultanée de S. mutans et de S. sobrinus était associée à un score de déformation plus élevé. La présence de S. mutans n'a pas montré de différence significative entre les enfants atteints de CEC et les enfants indemnes de caries (p=0,099), cependant, la proportion d'enfants atteints de CEC positifs pour S. sobrinus était significativement plus élevée que celle des enfants indemnes de caries (p= 0,003). CONCLUSIONS: S. mutans et S. sobrinus ont une fréquence d'apparition similaire chez les enfants atteints de CEC et les enfants indemnes de caries. La présence de S. mutans et de S. sobrinus dans l'ECC est liée à sa gravité. MOTS CLÉS: Streptococcus mutans, Streptococcus sobrinus, caries de lapetite enfance, plaque supragingivale.

Oral health status after orthodontic treatment: a retrospective study / Estado de salud bucal después del tratamiento de ortodoncia: un estudio retrospectivo

ABSTRACT: Orthodontic appliances in the oral cavity may cause problems such as white spot lesions, dental plaque, periodontal disease and root resorption. The aim of this study was to investigate the association between orthodontic treatment and oral health parameters including visible dental plaque, gingival recession and white spot lesions (WSLs). A total of 170 patients (86 females, 84 males) were randomly selected to determine visible dental plaque, gingival recession and white spot lesions by using pre-treatment and post-treatment oral photographs. Except of previously extracted teeth, maxillary and mandibular incisors, canine, 1st and 2nd premolars and 1st molar were evaluated. There was a significant difference between the T0 (before treatment) and T1 (after treatment) groups in visible plaque (P< 0.001). The distribution of gingival recession frequencies according to Miller classification before treatment did not differ from the after treatment (P=082). A statistically significant increase in the severity of WSL was detected between the two time points (P< 0.001). Males have been shown to have higher WSL incidence after treatment. In conclusion, the present study showed that visible dental plaque and white spot lesions significant increase after orthodontic treatment. Considering the relationship between oral health and orthodontic treatment, clinicians and patients should know the risks and take precautions.

RESUMEN: Los aparatos de ortodoncia en la cavidad oral puede causar problemas como lesiones de mancha blanca, placa dental, enfermedad periodontal y reabsorción radicular. El objetivo de este estudio fue investigar la asociación entre el tratamiento de ortodoncia y los parámetros de salud bucal, incluida la placa dental visible, la recesión gingival y las lesiones de mancha blanca (LMB). Un total de 170 pacientes (86 mujeres, 84 hombres) fueron seleccionados al azar para determinar la placa dental visible, la recesión gingival y las lesiones de manchas blancas mediante el uso de fotografías orales antes y después del tratamiento. Excepto los dientes extraídos previamente, se evaluaron incisivos maxilares y mandibulares, caninos, premolares y primeros molares. Hubo una diferencia significativa entre los grupos T0 (antes del tratamiento) y T1 (después del tratamiento) en la placa visible (P<0.001). La distribución de las frecuencias de recesión gingival según la clasificación de Miller antes del tratamiento no mostraron diferencias significativas con respecto al postratamiento (P=0.082). Se detectó un aumento estadísticamente significativo en la gravedad de LMB entre los dos puntos de tiempo (P<0.001). Se ha demostrado que los hombres tienen una mayor incidencia de LMB después del tratamiento. En conclusión, el presente estudio mostró que la placa dental visible y las lesiones de manchas blancas aumentaron significativamente durante el tratamiento de ortodoncia. Teniendo en cuenta la relación entre la salud bucal y el tratamiento de ortodoncia, los médicos y los pacientes deben conocer los riesgos y tomar precauciones.

The use of Lactobacillus reuteri DSM 17938 and ATCC PTA 5289 on oral health indexes in a school population: A pilot randomized clinical trial.

To assess the effects of a probiotic upon oral health indices in adolescents and to establish relationships between these indices and dietary habits and oral hygiene. Twenty-seven adolescents between 12 and 18 years of age were randomized into two groups. The study group received tablets containing Lactobacillus reuteri DSM 17938/ATCC 5289 for 28 days, while the control group received tablets without any bacteria. Streptococcus mutans, Lactobacillus sp., and salivary pH were assessed at baseline and at 7, 14, 21, 28, and 45 days. The plaque, gingivitis, and bleeding indices were recorded at baseline and at 14, 28, and 45 days. Dietary and oral hygiene habits were also evaluated by means of a questionnaire. A less marked rise in S. mutans was recorded in the study group. Improvements were observed in terms of plaque, gingivitis, and bleeding, though statistical significance was not reached. Oral pH increased in the study group, though not to a significant degree. Poorer eating habits were significantly correlated to increased plaque. The study parameters decreased with the two strains of L. reuteri DSM 17938 and ATCC PTA 5289, though the results failed to reach statistical.

Associations between depression and gingivitis among adolescents resident in semi-urban South-West Nigeria.

OBJECTIVE: None of the past studies that had showed a linked between oral and mental health among adolescents was conducted in Nigeria. The objective of this study was to determine the association between gingivitis and depression among adolescents in Ile-Ife, South-West Nigeria. METHODS: This cross-sectional study collected data through a household survey conducted between December 2018 and January 2019. Adolescents aged 10 to 19 years old were identified using multistage sampling. The study outcome measure was gingivitis, measured by the Löe and Silness gingival index. The explanatory variable was depression, measured by the Patient Health Questionnair. Confounders considered were age, sex, socioeconomic status, frequency of daily tooth brushing, oral hygiene status (measured by the plaque index), consumption of refined carbohydrates in-between meals, use of dental floss, and history of dental service utilization in the past 12 months. A logistic regression model was constructed to determine risk indicators for moderate/severe gingivitis. Additionally, modification of associations between dependent variables and the significant risk indicators of depression was assessed. RESULTS: Mean plaque index for the 1,087 adolescent participants enrolled in the study was 0.80. We found a prevalence of 8.5% for moderate/severe gingivitis and 7.9% for depression. In adjusted regression, there were significant associations between the presence of moderate/severe gingivitis and consumption of refined carbohydrates in-between meals (OR 1.94, 95% CI 1.14, 3.28) and plaque index (OR 16.56, 95% CI 10.03, 27.33). Depression also significantly modified the association between plaque index and the presence of moderate/severe gingivitis (P < 0.0001), with a stronger association observed with mild depression (OR 24.75, 95% CI 3.33, 184.00) compared with no depression (OR 15.47, 95% CI 9.31, 25.69), with no significant modification for the association with frequent consumption of refined carbohydrates (P = 0.06). CONCLUSION: Although there was no significant association between gingivitis and depression among our adolescent Nigerian cohort, depression significantly modified the association between plaque index score and moderate/severe gingivitis.

Phenotypic and genetic characteristics of Streptococcus mutans isolates from site-specific dental plaque in China.

Introduction. Streptococcus mutans is an important cariogenic microbe.Hypothesis/Gap Statement. The potential characteristics of S. mutans isolates from site-specific dental plaque are still not clear.Aim. This study aimed to investigate the phenotypic and genetic characteristics of S. mutans isolates from site-specific dental plaque in China.Methodology. We used S. mutans isolated from children with early-childhood caries (ECC) and caries-free children to compare the phenotypic and genetic characteristics of S. mutans from site-specific dental plaque samples. The ECC subjects presented two sites: a cavitated lesion and a sound surface. The caries-free subjects presented one sound surface. Growth pattern, biofilm, decrease in pH, extracellular polysaccharide, expression levels of virulence-related genes, multilocus sequence typing (MLST) and phylogenetic trees were evaluated among these three sites.Results. The phenotypes detected between the cavitated and sound surfaces of ECC children were similar. However, the capacity for biofilm formation, pH drop and expression levels of genes (gtfB and spaP) of S. mutans in the caries-free group were lower compared with those of the ECC group. We identified 44 new alleles and 77 new sequence types. More than 90 % of the children with ECC shared an identical sequence type. The distribution of sequence types among different subjects showed diversity, and child-to-child transmission was detected.Conclusions. This is the first report of MLST on site-specific dental plaques in a single subject, and indicates that S. mutans isolated from site-specific dental plaque of a single subject showed similar phenotypes as a result of the isolates were closely related.

Factors Associated with Dental Plaque, Gingivitis, and Caries in a Pediatric Population: A Records-Based Cross-Sectional Study.

This retrospective, cross-sectional study evaluated dental records of 1000 healthy children to determine factors associated with plaque, gingivitis, and caries. A logistic model for plaque and gingivitis (mild versus moderate/severe) and caries (yes/no) was carried out separately for each variable using the following potential factors: Age, Gender, Brush Type, Starting Age of Brushing, Brushing Frequency, and Bite Type. Data from 998 children (median age: 4 years, 10 months (range: 2.5-7 years)) were analyzed. Sixty-four percent were manual toothbrush users; 36% were oscillating-rotating electric toothbrush users. For plaque and gingivitis, but not caries, Brush Type was more impactful than Brushing Frequency. Age influenced the severity of plaque and gingivitis, with increases in the odds of having moderate/severe plaque or gingivitis associated with increasing age. The probability of caries increased until approximately age 5 and then decreased until age 7. Oscillating-rotating brush users were more likely to present with less plaque, gingivitis, and caries, with 6.0, 5.1, and 1.4 times greater odds of having mild (versus moderate/severe) plaque, less severe gingivitis, and being caries-free, respectively, than manual brush users. Similarly, brushing twice daily and starting brushing at an earlier age were associated with better oral health outcomes. Children with anterior bite abnormalities had increased odds of developing moderate/severe plaque and gingivitis than children with normal anterior bites. Gender was not a statistically significant factor associated with plaque, gingivitis, or caries. Children's oral health is influenced by toothbrush type, starting age of brushing, compliance with twice-daily brushing, and bite abnormalities.

Ethnic variation of oral microbiota in children.

Despite widely used preventive measures such as sealant programs to control caries prevalence, disparities are seen among ethnic groups. Supragingival plaque harbors hundreds of bacterial species, playing a significant role in oral health and disease. It is unknown whether the ethnic variation influences the supragingival microbiota in children. In our study, variations in microbiota of the supragingival plaque was investigated from 96 children between 6 and 11 years old in four ethnic groups (African American, Burmese, Caucasian, and Hispanic) from the same geographic location by 16S rRNA gene sequencing. We found that the microbial alpha and beta diversity of supragingival microbiota significantly differed between ethnic groups. The supragingival plaque microbiota had the most complex microbial community in Burmese children. Within-group microbiota similarity in Burmese or Caucasian children was significantly higher than between-groups similarity. We identified seven ethnic group-specific bacterial taxa after adjusting for dental plaque index, decayed missing filled teeth (DMFT) and the frequency of brushing. Children with high plaque index and high DMFT values were more similar to each other in the overall microbial community, compared to low plaque index or low DMFT groups in which inter-subject variation is high. Several bacterial taxa associated with high plaque index or high DMFT were ethnic group-specific. These results demonstrated that supragingival microbiota differed among ethnicity groups in children.

Metagenomic investigation of bacteria associated with dental lesions: a cross-sectional study

BACKGROUND: Dental caries is considered as one of the most significant global health problem over the world. Dental caries initiates from bacterial shifts within the supragingival biofilm, then a polymicrobial biofilm is formed on the surface of tooth, and finally various bacterial species aggregate in a complex-organized manner. The exploiting variability in 16S rRNA gene sequence has been considered as a cost-efficient high-throughput characterization approach in human oral microbiome investigations. The aim of this study is to characterize bacterial species associated with superficial dental biofilm, underlying carious dentine and root caries lesion by16S rRNA gene-based metagenomic analysis. MATERIAL AND METHODS: Herein, the bacterial communities in carious dentin lesion, biofilm and root canal samples of 30 subjects (aged 4-76 years) admitted to a clinic in Tehran during 2017 were investigated using a culture independent approach. Total genomic DNA of each tissue was subjected to metagenomic identification of bacteria using a nested PCR assay and 16S rRNA library construction method. RESULTS: 31 samples collected from 30 consenting patients (29 samples from 29 patients ant two biofilm samples from one patient). Bioinformatics analyses of a-800bp sequences of the second step of Nested-PCR revealed presence of 156 bacterial isolates in carious (n = 45), biofilm (n = 81) and root canal (n = 30) specimens. Prevotella spp., Lactobacillus vaginalis, and streptococcus spp. showed higher prevalence in carious dentin, root and biofilm samples, respectively. CONCLUSIONS: Exploring the dental microbiota and comparing them in health or diseased conditions is critical step in the determination of human general health. The method applied in this study could identify bacteria related to the three dental lesions. However, due to lack of data for comparison in Genbank or because of the sequence similarity lower than 98% for most identified bacteria, the use of more powerful approaches like NGS platforms or typing of multiple loci (MLST) in future studies is recommended

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Oral health status of children with phenylketonuria.

Background Diet plays an integral role in the maintenance of oral health, but dietary modifications due to medical problems such as phenylketonuria (PKU) can have adverse effects on oral health. This descriptive study was performed to evaluate the oral health status of children with PKU. Methods One hundred and ninety-seven patients with PKU aged between 1 and 22 years were evaluated. Clinical evaluations were performed by one experienced dentist regarding dental caries, gingival health and dental erosion. Categorical variables were assessed with descriptive statistics. Differences in feeding frequencies and sociodemographic characteristics were compared regarding dental caries using chi-square (χ2) tests. Results One hundred and thirty-two patients (67%) had dental caries. The mean plaque index (PI) and gingival index (GI) values were 1.37 ± 0.58 and 1.40 ± 0.64, respectively, which shows moderate plaque accumulation and moderate gingival inflammation. Of the patients, 85.3% did not brush their teeth regularly and 90.4% had never visited a dentist before. No statistically significant differences were found in dental caries according to feeding frequencies (p = 0.448). Conclusions Despite the high prevalence of caries in patients with PKU, most had never seen a dentist. Physicians must encourage patients with PKU and their parents to have regular dental visits to maintain an optimal general and oral health.

The effect of preventive oral care on postoperative infections after head and neck cancer surgery.

OBJECTIVE: This study aimed to investigate the incidence of postoperative pneumonia (PP) and surgical site infection (SSI) in head and neck cancer (HNC) patients and clarify the relationship between oral care and postoperative infection. METHODS: We conducted a retrospective observation survey based on the medical records of 209 HNC surgery patients managed at a University Hospital in 2016-2018. The incidence of PP and SSI were assessed in patients who underwent operations of the nose and paranasal sinuses to the larynx. Factors associated with PP and SSI in a univariate analysis were included in a multiple logistic regression analysis. A Cox proportional hazards model was used analyze the incidence of PP according to time after surgery. The present study was approved by the ethical review board of our Institute. RESULTS: The rates of PP and SSI in our study population were 20.5% and 23.0%. Operative time (P < 0.01), blood loss (P = 0.004), tracheostomy (P < 0.01), reconstruction (P < 0.01), and preoperative plaque control record (PCR) (P < 0.01) were significantly associated with PP. The PCR depicted the oral hygiene based on the percentage of plaque attached to the tooth neck. A multiple logistic regression analysis indicated that the incidence of PP was significantly higher in patients with PCR values of ≥50% after preoperative oral care (OR=10.174, 95% CI 2.14-48.32, P = 0.004). Tracheostomy (P < 0.01), reconstruction (P = 0.044), a lower preoperative albumin level (P = 0.019), and a lower preoperative hemoglobin level (P < 0.01) were significantly associated with SSI. CONCLUSIONS: The incidence of PP among patients who received oral care was high in those patients with high PCR values, indicating the importance of increasing compliance to preoperative oral care.

Current status of periodontal disease in adults in Takahagi, Japan: a cross-sectional study.

BACKGROUND: To date, a few studies have documented the detailed periodontal conditions of a Japanese population. It is important to know if the awareness of Japanese nationals and dentists regarding oral hygiene and prevention of periodontal disease have improved when compared with the past in Japan for the development of future scenarios regarding prevention. The aim of this study was to investigate the severity, prevalence, and extent of periodontal disease in the adult population of the city of Takahagi, Japan. Results were also compared with those of an epidemiological study performed in Japan in the 1980s. METHODS: A total of 582 (aged 20 to 89 years) randomly sampled Takahagi residents answered a comprehensive questionnaire and participated in clinical examinations. RESULTS: The mean percentages of tooth surfaces harboring plaque and exhibiting BOP were 59.5 ± 20.9% and 31.1 ± 21.1%, respectively. The mean PPD and CAL were 2.5 ± 0.5 mm and 2.9 ± 1.0 mm, respectively. Compared with results of the 1980s survey, the mean percentages of plaque and bleeding on probing were lower in the current population. The mean CAL and prevalence of attachment loss of ≥5 mm in some age groups were higher in the present study than in the 1980s study. There were no statistically significant differences with respect to mean probing depth between the 1980s and current age groups. CONCLUSIONS: Periodontal disease was still prevalent in the current Japanese population, even though some improvement occurred. Proper public health programs therefore need to be established.

Influence of customized therapy for molar incisor hypomineralization on children's oral hygiene and quality of life.

OBJECTIVE: The aim of this clinical follow-up study was to demonstrate the effects of different therapeutic strategies for hypomineralized teeth on patients' oral health. The treatment results were characterized by changes in the extent of hypersensitivity and plaque accumulation, as well as reductions in nutritional restrictions. MATERIAL AND METHODS: The impacts of therapy, including the use of fluoride varnish, fissure sealants, fillings, and stainless steel crowns, were evaluated in 78 children (mean age 8.5 years). We followed recommendations according to the Molar Incisor Hypomineralisation Treatment Need Index for customized treatment. The Quigley Hein Index, the Schiff Cold Air Sensitivity Scale, Wong-Baker Faces Scale, and dietary-limiting parameters were assessed before and after therapy for comparison. RESULTS: Plaque accumulation and hypersensitivity decreased after completion of therapy. The improvements were greater for individual teeth (Quigley Hein Index for teeth treated with stainless steel crowns from 4.19 to 2.54) than for those of the whole dentition (high-severity category from 2.67 to 2.20). Problems with food intake were minimized via therapy, with the greatest influence observed for patients who were also in the high-severity category. CONCLUSIONS: Therapy for affected teeth in children has positive effects on oral health and quality of life.